Sample Record

Owner Lab

  • Alta Vista Solutions - Whittier

DIME Sample ID 2024-12-24-2

Project Information

Project IdentifiersProject ID: 994582
DEA: 073203U4
EFIS: 0722000071
DIST-CO-RTE-PM07-LA-91,605-R16.6/R16.8,R0.0/R10.4
Award Date06/20/2023
Closeout DateNot set
Work DescriptionPLACE CONCRETE PAVEMENT AND HIGH FRICTION SURFACE TREATMENT.
Location DescriptionLOS ANGELES COUNTY ON ROUTE 605 FROM 0.2 MILE NORTH OF KATELLA AVENUE UNDECROSSING TO 0.1 MILE NORTH OF TELEGRAPH ROAD UNDERCROSSING AND ON ROUTE 91 FROM 0.4 MILE WEST OF ROUTE 605 UNDERCROSSING TO 0.2 MILE WEST OF ROUTE 605 UNDERCROSSING
QA Service Level1 (Verified on 07/12/2023)

Sample Information

Sample Taken Date12/24/2024 Sample Unique Key2
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing12/14/2024
Sample typeQuality Assurance A brief description of the sample3 - 6X6X21 Rapid Set Concrete Beams
The quantity of what the sample constitutes10 CY From where was the sample collectedJob Site
First name of sampler or witnessed byAleksey Last name of sampler or witnessed bySouglobov
Title of samplerMaterials Tester Telephone number of sampler7075835090
Laboratory sample identification24-3880 Linked DIME Sample ID
The fabricator/manufacturer/facility nameN/A Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberHE4x12BM
The truck number from where the sample was collectedTruck 7 The batch plant ticket number from where the sample was collectedLoad 85
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedJobsite Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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